| NPI | 1366222192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71014571A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28240995A) |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2023-12-29 |